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John Gavazzi, PsyD ABPP - June 2011 This .ppt was part of a 3 hour workshop. I spent 45 minutes on the slide show. My co-presenter spent 45 minutes disclosing ethical decision-making issues, and we discussed vignettes for about 1 hour, using the questions at the end.
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READINGS: Introduction Unit II examines ethical, legal, and legislative issues affecting leadership and management as well as professional advocacy. This chapter focuses on applied ethical decision making as a critical leadership role for managers. Chapter 5 examines the impact of legislation and the law on leadership and management, and Chapter 6 focuses on advocacy for patients and subordinates and for the nursing profession in general. Ethics is the systematic study of what a person’s conduct and actions should be with regard to self, other human beings, and the environment; it is the justification of what is right or good and the study of what a person’s life and relationships should be, not necessarily what they are. Ethics is a system of moral conduct and principles that guide a person’s actions in regard to right and wrong and in regard to oneself and society at large. Ethics is concerned with doing the right thing, although it is not always clear what that is. Applied ethics requires application of normative ethical theory to everyday problems. The normative ethical theory for each profession arises from the purpose of the profession. The values and norms of the nursing profession, therefore, provide the foundation and filter from which ethical decisions are made. The nurse-manager, however, has a different ethical responsibility than the clinical nurse and does not have as clearly defined a foundation to use as a base for ethical reasoning. In addition, because management is a discipline and not a profession, its purpose is not as clearly defined as medicine or law; therefore, the norms that guide ethical decision making are less clear. Instead, the organization reflects norms and values to the manager, and the personal values of managers are reflected through the organization. The manager’s ethical obligation is tied to the organization’s purpose, and the purpose of the organization is linked to the function that it fills in society and the constraints society places on it. So, the responsibilities of the nurse-manager emerge from a complex set of interactions. Society helps define the purposes of various institutions, and the purposes, in turn, help ensure that the institution fulfills specific functions. However, the specific values and norms in any institution determine the focus of its resources and shape its organizational life. The values of people within institutions influence actual management practice. In reviewing this set of complex interactions, it becomes evident that arriving at appropriate ethical management decisions can be a difficult task. In addition, nursing management ethics are distinct from clinical nursing ethics . Although significant research exists regarding ethical dilemmas and moral distress experienced by staff nurses in clinical roles, less research exists regarding the ethical distress experienced by nursing managers. Nursing management ethics are also distinct from other areas of m.
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The Four Topics Approach to Ethical Decision Making Jonsen and colleagues’ (2010) Four Topics Method for ethical analysis is a practical approach for nurses and other healthcare professionals. The nurse or team begins with relevant facts about a particular case and moves toward a resolution through a structured analysis. In healthcare settings, ethics committees often resolve ethical problems and answer ethical questions by using a case-based, or bottom-up, inductive, casuistry approach. The Four Topics Method, sometimes called the Four Box Approach (Table 2-1) is found in the book Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine (Jonsen et al., 2010). This case-based approach allows healthcare professionals to construct the facts of a case in a structured format that facilitates critical thinking about ethical problems. Cases are analyzed according to four topics: “medical indications, patient preferences, quality of life, and contextual features” (Jonsen et al., 2010, p. 8). Nurses and other healthcare professionals on the team gather information in an attempt to answer the questions in each of the four boxes. The Four Topics Method facilitates dialogue between the patient–family/surrogate dyad and members of the healthcare ethics team or committee. By following the outline of the questions, healthcare providers are able to inspect and evaluate the full scope of the patient’s situation and the central ethical conflict. After the ethics team has gathered the facts of a case, an analysis is conducted. Each case is unique and should be considered as such, but the subject matter of particular situations often involves common threads with other ethically and legally accepted precedents, such as landmark cases that involved withdrawing or withholding treatment. Though each case analysis begins with facts, the four fundamental principles—autonomy, beneficence, nonmaleficence, and justice—along with the Four Topics Method are considered together as the process, and resolution take place (Jonsen et al., 2010). TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases Medical Indications: The Principles of Beneficence and Nonmaleficence 1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal? 2. What are the goals of treatment? 3. In what circumstances are medical treatments not indicated? 4. What are the probabilities of success of various treatment options? 5. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided? Patient Preferences: The Principle of Respect for Autonomy 1. Has the patient been informed of benefits and risks, understood this information, and given consent? 2. Is the patient mentally capable and legally competent, and is there evidence of incapacity? 3. If mentally capable, what preferences about treatment is the patient stating? 4. If incapacitated, has the patient expressed prior ...
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READINGSIntroductionUnit II examines ethical, legal, and .docx
READINGSIntroductionUnit II examines ethical, legal, and .docx
MODULE 15 - HOW TO RESOLVE ETHICAL ISSUES IN CLINICAL PRACTICE
MODULE 15 - HOW TO RESOLVE ETHICAL ISSUES IN CLINICAL PRACTICE
2009 Plant Ferti Grow Fresnochilddev Pres
2009 Plant Ferti Grow Fresnochilddev Pres
Although supportive psychotherapy and interpersonal ps
Although supportive psychotherapy and interpersonal ps
The Four Topics Approach to Ethical Decision MakingJonsen and c.docx
The Four Topics Approach to Ethical Decision MakingJonsen and c.docx
Evidence-Based Practice in Health Care Management
Evidence-Based Practice in Health Care Management
Loray pe charg.pptx
Loray pe charg.pptx
Pl 2 ethics_020713_rev
Pl 2 ethics_020713_rev
Chaunceywilson
Chaunceywilson
Interactive Ethics
Interactive Ethics
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Chapter 04 ethical and legal issues affecting nursing assistant
Chapter 04 ethical and legal issues affecting nursing assistant
Mandated reporter tng for child mal 2011 (2)
Mandated reporter tng for child mal 2011 (2)
Chapter 015
Chapter 015
Chapter 014
Chapter 014
Chapter 013
Chapter 013
Abuse and neglect
Abuse and neglect
Chapter14
Chapter14
Chapter12
Chapter12
Chapter05
Chapter05
Chapter04
Chapter04
Chapter03
Chapter03
Chapter02
Chapter02
Ethics of health care introduction
Ethics of health care introduction
Attaching assignments in blackboard
Attaching assignments in blackboard
Abuse and neglect
Abuse and neglect
Microsoft® office word 2003 a
Microsoft® office word 2003 a
Microsoft® office word 2003 a
Microsoft® office word 2003 a
Pressure ulcer presentation3
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Chapter06
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Chapter Six Professional
Gatekeeping as a Function of Role Fidelity
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